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C N Gluud

Publications and source records attributed to C N Gluud.

13 recordsLinked to original sources
PubMed2001

[What is evidence-based medicine?].

Evidence-based medicine is based on the best results from clinical and epidemiological research, which is combined with clinical experience and patient preferences. Questions of prognosis and harm are often best elucidated in large cohort studies. For other clinical questions the best evidence is usually found by systematic review of randomised trials, if possible in the form of meta-analyses. To make a diagnosis is, for example, not an aim in itself but a way to arrive at a prognosis and to suggest a treatment, provided this leads to a better prognosis. The most relevant, albeit rarely seen, test of a diagnostic method is a randomised trial. Evidence-based medicine will provide the best basis for evaluations of which interventions should be abandoned and which are effective and economically feasible. The use of evidence-based clinical guidelines will lead to more cost-effective treatments. It should be a national strategy that health care should be evidence-based.

Cost-Benefit Analysis↗
PubMed1999

[Infections and cardiovascular disease].

Epidemiological studies indicate that respiratory tract and dental infections increase the risk of atherosclerotic cardiovascular disease. Several microorganisms have been claimed as clinically important, especially Chlamydia pneumoniae (Cp) and cytomegalovirus (CMV), Cp is frequently isolated from atherosclerotic plaques, and treatment with macrolide antibiotics may have a beneficial effect on the course of ischaemic heart disease. CMV seems to play a role in the development of coronary stenosis following coronary bypass surgery and heart transplantation. Likewise, inflammatory markers are associated with atherosclerotic cardiovascular disease. The pathogenetic role of microorganisms may be ascribed to the inflammatory response, which is elicited during infection. There is an urgent need for more documentation of the role of microorganisms in cardiovascular disease, and of the possible clinical effect of antibiotic treatment.

Anti-Bacterial Agents↗
PubMed1998

Outpatients' knowledge about and attitude towards clinical research and randomized clinical trials. The INFO Trial Group.

OBJECTIVES: To investigate the knowledge about randomized clinical trials and the attitude towards clinical research among Danish outpatients and to examine the relationships between outpatient demographic variables and knowledge and attitude. SETTING: Outpatients (n = 415) were recruited from four departments at a university hospital in Copenhagen. METHODS: The participants answered an 18 item multiple choice test evaluating knowledge about randomized clinical trials and a 32 item Likert format questionnaire evaluating attitudes towards clinical research in general and randomized clinical trials. Assessment of scales for knowledge and attitudes was performed using Rasch analysis and Cronbach's alpha. Associations between demographic variables, knowledge score and attitude score were examined using analysis of variance. RESULTS: Mean age for all outpatients was 46 years (range 18-88 years); 251 (60%) were females. A total of 27 outpatients (7%) had previously participated in a randomized clinical trial. Mean knowledge score (number of correct answers out of a maximum of 17) was 7.9 (SD 3.1). Patients in the younger age groups and patients with longer education had significantly higher knowledge scores (p < 0.001). The effect of age group (estimated increase in knowledge score relative to the group 60-89 years) was: 18-29 years 1.2 (SE 0.4); 30-39 years 2.0 (SE 0.4); and 40-59 years 1.6 (SE 0.4). The effect of education (estimated decrease in knowledge score relative to patients with > 12 years of education) was: < 7 years 3.4 (SE 0.4); and 8-11 years 2.0 (SE 0.3). Mean total attitude score was 74.8 (SD 14.8) on a scale from 0-128. Compared to female patients, male patients had an estimated 5.1 points (SE 1.5) higher attitude score (p < 0.001). There was a weak but significant positive association (r = 0.38; p < 0.001) between the knowledge score and the total attitude score. CONCLUSION: Among Danish outpatients knowledge about randomized clinical trials is better in the younger age groups and in individuals with longer education. Overall, better knowledge was associated with a more positive attitude towards clinical research. The question is whether it is possible by simple means to increase knowledge about clinical research and whether an increase in knowledge may positively affect the attitude towards clinical research in individual patients.

Adolescent↗
PubMed1996

[Prognostic markers for weight loss in the treatment of obesity].

The aim of the study was to identify prognostic metabolic markers for long-term weight loss outcome in obese women. Forty female obese patients underwent a dietary intervention of 36 weeks treatment with a 4.2 MJ/d low-fat high carbohydrate diet and were followed-up two and a half years after cessation of treatment. The maximum weight loss (mean 16.2 kg. 95% CI 14.2-18.2) was positively associated to pre-treatment 24-h energy expenditure (EE) (p < 0.01), fat oxidation (%) (p < 0.02), plasma dihydrotestosterone (DHT) (p < 0.01), and to postprandial noradrenaline concentration (p < 0.04). Together these factors could explain 41% of the variation in maximum weight loss. After 36 weeks only 24-h EE and DHT had predictive power on weight loss. Weight losses in upper and lower tertiles of DHT concentrations were 17.7 kg (14.1-21.4) and 9.8 kg (6.2-13.3) (p < 0.02) and the adjusted relative risk of losing < 10 kg in the upper compared to the lower DHT tertile was 12% (4-32%). At two and a half years follow-up 21 patients had maintained some of the weight loss (54%), while 14 patients had maintained > 5 kg weight loss (36%). High levels of pre-treatment DHT were also associated with better weight loss at two and a half years follow-up. The study suggests that long-term weight loss outcome may be predicted by pre-treatment metabolic and hormonal factors in obese women.

Adolescent↗
PubMed1994

[Liver pathology associated with anabolic androgenic steroids].

This review regards the liver damaging side-effects of anabolic-androgenic steroids (AAS). It seems that AAS can cause development of peliosis hepatis, subcellular changes of hepatocytes, hepatocellular hyperplasia and hepatocellular adenomas. On the other hand, it has not been convincingly proved that AAS can cause development of hepatocellular carcinomas when used in usual therapeutical doses. Tumours reported as hepatocellular carcinomas caused by AAS seem to be hyperplastic lesions of a benign nature that are able to regress on withdrawal of the putative agent. The effect of untraditional combinations of AAS and high-dose AAS is not yet known, leaving the possibility of a carcinogenic effect in those cases.

Anabolic Agents↗
PubMed1976

Effect of glucagon on cyclic AMP, albumin metabolism and incorporation of 14C-leucine into proteins in isolated parenchymal rat liver cells.

Parenchymal rat liver cells were isolated by the collagenase method and incubated in Krebs-Henseleit buffer containing 0.5% gelatin. The basal level of cyclic AMP in isolated cells was 0.52 nmol per g liver wet wt. Glucagon (10(-10)-10(-6) M) caused a significant increase in the level of cyclic AMP. Maximum levels were obtained 2-15 min after addition of glucagon. Repeated administration of glucagon caused a new increase in cyclic AMP, but the response was lesser than after the first addition of glucagon, indicating refractoriness to glucagon. The rate of albumin secretion was 4.6 mug/min per g liver wet wt. This is about the rate found in the perfused liver, Glucagon (10(-8-10(-6) M) inhibited albumin secretion and the incorporation of 14C-leucine into albumin, into total proteins in the medium and into total proteins in the cell suspension. The effect of glucagon on albumin secretion is compatible with an effect on the rate of synthesis. A positive correlation existed between the maximal level of cyclic AMP after glucagon administration and the inhibition of both albumin secretion and the incorporation of 149leucine.

Albumins↗
PubMed1975

Effect of insulin on albumin production and incorporation of 14C-leucine into proteins in isolated parenchymal liver cells from normal rats.

Parenchymal rat liver cells were isolated by a modification of the collagenase method of Quistorff, Bondesen and Grunnet. The cells secreted albumin into the medium and incorporated 14C-leucine both into cell proteins and proteins secreted into the medium. Albumin production measured from the immunologically determined increment in the incubation medium was 1.7 +/- 0.2 mug albumin/min per g liver wet wt. This is about 30% of the rate of production in the perfused liver. Addition of insulin (10(-6)-10(-10) M) enhanced albumin production (50-17%), and incorporation of 14C-leucine both into albumin (50-8%), secreted proteins (40-9%) and cell proteins (20-8%). Insulin does not increase the production of albumin by depleting the cells. The effect of insulin on albumin production is compatible with an effect on the rate of synthesis as the specific activity of albumin is unaffected by addition of insulin.

Albumins↗